ArticleBMC health services research2018
Two decades of antenatal and delivery care in Uganda: a cross-sectional study using Demographic and Health Surveys.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.
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Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Private sector quality of care for maternal, new-born, and child health in low-and-middle-income countries: a secondary review.Frontiers in global women's health · 2024Pooled it
- Impact of cesarean section on timely initiation of breastfeeding in Ethiopia: a systematic review and meta-analysis.International breastfeeding journal · 2021Pooled it
- Trial
- Population-level viral suppression among pregnant and postpartum women in a universal test and treat trial.AIDS (London, England) · 2020Trial
- A multilevel modelling approach to understanding antenatal care utilisation in Uganda.BMC pregnancy and childbirth · 2026Article
- Health insurance coverage and health service utilisation in Uganda: an analysis of the 2016 Uganda Demographic and Health Survey.BMC health services research · 2026Article
- Assessing quality of childbirth care provided by skilled health personnel in Exemplar countries.Nature medicine · 2026Article
- "As long as you are married you cannot protect yourself against syphilis": qualitative exploration of syphilis risk perception and antenatal care seeking among pregnant women in Uganda.BMC public health · 2026Article
- A systematic review of implementation strategies to improve timely initiation of antenatal care among pregnant women in sub-Saharan Africa.Journal of public health in Africa · 2026Review
- Article
- Beyond facility-based births: Is Uganda delivering effective maternal and newborn care? An analysis of the 2022 demographic health survey and 2023 harmonized health facility assessment survey.PLOS global public health · 2025Article
- Association of remittances with skilled delivery in Uganda, 2019/2020.PLOS global public health · 2025Article
- Article
- Trends and geospatial distribution of stillbirths in Uganda, 2014-2020.BMC pregnancy and childbirth · 2024Article
- Inequalities in use of hospitals for childbirth among rural women in sub-Saharan Africa: a comparative analysis of 18 countries using Demographic and Health Survey data.BMJ global health · 2024Article
- Article
- The adequacy of ANC components received and associated factors among women of reproductive age in Tanzania.PloS one · 2024Article
- Do private health providers help achieve Universal Health Coverage? A scoping review of the evidence from low-income countries.Health policy and planning · 2023Article
- Impacts of the COVID-19 Lockdown on Healthcare Inaccessibility and Unaffordability in Uganda.The American journal of tropical medicine and hygiene · 2023Article
- Completion of four or more ANC visits among women of reproductive age in Iganga district in Uganda: a quantitative study on the role of service-level factors.BMC health services research · 2023Article
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16 authors.
Funding
Abstract
backgroundUganda halved its maternal mortality to 343/100,000 live births between 1990 and 2015, but did not meet the Millennium Development Goal 5. Skilled, timely and good quality antenatal (ANC) and delivery care can prevent the majority of maternal/newborn deaths and stillbirths. We examine coverage, equity, sector of provision and content of ANC and delivery care between 1991 and 2011.
methodsWe conducted a repeated cross-sectional study using four Uganda Demographic and Health Surveys (1995, 2000, 2006 and 2011).Using the most recent live birth and adjusting for survey sampling, we estimated percentage and absolute number of births with ANC (any and 4+ visits), facility delivery, caesarean sections and complete maternal care. We assessed socio-economic differentials in these indicators by wealth, education, urban/rural residence, and geographic zone on the 1995 and 2011 surveys. We estimated the proportions of ANC and delivery care provided by the public and private (for-profit and not-for-profit) sectors, and compared content of ANC and delivery care between sectors. Statistical significance of differences were evaluated using chi-square tests.
resultsCoverage with any ANC remained high over the study period (> 90% since 2001) but was of insufficient frequency; < 50% of women who received any ANC reported 4+ visits. Facility-based delivery care increased slowly, reaching 58% in 2011. While significant inequalities in coverage by wealth, education, residence and geographic zone remained, coverage improved for all indicators among the lowest socio-economic groups of women over time. The private sector market share declined over time to 14% of ANC and 25% of delivery care in 2011. Only 10% of women with 4+ ANC visits and 13% of women delivering in facilities received all measured care components.
conclusionsThe Ugandan health system had to cope with more than 30,000 additional births annually between 1991 and 2011. The majority of women in Uganda accessed ANC, but this contact did not result in care of sufficient frequency, content, and continuum of care (facility delivery). Providers in both sectors require quality improvements. Achieving universal health coverage and maternal/newborn SDGs in Uganda requires prioritising poor, less educated and rural women despite competing priorities for financial and human resources.
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